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I hate DRUGS!! > Drug interactions > Flashcards

Drug interactions Flashcards

1
Q

Alcohol

A
  • CNS depressans
    • additive CNS depression, sedation, ataxia, increased risks of accidents
  • Acetaminophen
    • Increased formation of hepatotoxic metabolites of acetamonophen
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2
Q

Antacid

A
  • Digoxin, iron supplements, fluoroquinolones, ketoconazole, tetracyclines, thyroxine
    • Decreased gut absorption due to either to reaction with the affected drug or due to reduced acidity
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3
Q

Antihistamines

A
  • Antimuscarinis, sedatives
    • Additive effects with the drugs affected
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4
Q

Antimuscarnic drugs

A
  • Drugs absorbed from the small intestine
    • Slowed onset of effect because stomach emptying is delayed
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5
Q

Barbiturates (phenobarbital)

A
  • Azoles, CCB, cyclosporine, propanol,protease inhibitors, quinidine, steroids, warfarin, kinase inhibitors, methadone, ansd many other drugs metabolzied in the liver
    • Increased clearance of the affected drugs due to enzyme induction, possibly leading to decreases in drug effectiveness
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6
Q

Beta blockers

A
  • Insulin
    • masking of symptoms of hypoglycemia
  • Prazosin
    • increased first dose syncope
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7
Q

Bile acid-binding resins

A
  • Acetaminophen, digitalis, thiazides, thyroxine
    • Reduced abdorption of the affected drug
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8
Q

Carbamazepine

A

Cyclosporine, lidocaine, phenytoin, propanolol, quinidine, theophylline, warfarin, dofetilide

Reduced effect of other drugs because of induction of metabolism

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9
Q

Cimetidine

A

BZ, lidocaine, phenytoin, propanol, quinidine, theophylline, warfarin, dofetilide

Risk of toxicity due to inhibition of metabolism or reduced renal excretion

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10
Q

Disulfiram, metronidazole, certain cephalosporins

A

Ethanol

Increased hangover effect due to inhibition of aldehyde dehydrogenase

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11
Q

Erythromycin

A

Carbamazepine, cisaparide, quinidine, sildenafil, SSRIs

Risk of toxicity due to to inhibition of metabolism

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12
Q

Furanocoumarins (grapefruit)

A

Alprazolam, atorvastatin, cyclosporine, midazolam, nifedipine

Risk of toxicity due to inhibition of metabolism

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13
Q

ketoconazole and other azoles

A

Benzodiazepines, cisapride, cyclosporine, fluoxetine, lovastatin, omeprazole, quinidine, tolbutamide, oral anticoagulants (warfarin, apixaban, rivaroxaban)

Risk of toxicity due to inhibition of metabolism, Increased bleeding with oral anticoagulants, myopathy with statins

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14
Q

MAO inhibitors

A
  • Catecholamine releasers (amphetamine, ephedrine)
    • Increased norepinephrine in sympathetic nerve endings released by the interacting
  • Tyramine-containing foods and beverages
    • hypertensive crisis
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15
Q

NSAIDs

A
  • Anticoagulants
    • Increased bleeding tendency because of reduced platelt aggregation
  • ACE inhibitors
    • Decreased hypertensive efficacy of ACE inhibitor
  • Loop diuretics
    • reduced diuretic efficacy
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16
Q

Phenytoin

A

Doxycycline, methadone, quinidine, steroids, verapamil, anticoagulants

Reduced effect of other drugs because of induction of metabolism

17
Q

Rifampin

A

Azole antifungal drugs, corticosteroids, methadone, sulfonylureas, oral anticoagulants

Reduced effect of other drugs because of induction of metabolism

18
Q

Ritonavir

A

Benzodiazepines, cyclosporine, diltiazem, HMG-CoA reductase inhibitors, lidocaine, metoprolol, other HIV protease inhibitors, SSRIs

Risk of toxicity due to inhibition of metabolism

19
Q

Salicylates

A
  • Corticosteroids
    • Additive toxicity to gastric mucosa
  • Heparin, oral anticoagulants
    • increased bleeding tendency
  • MEthotrexate
    • decreased clearance, causing greater methotrexate toxicity
  • Sulfinpyrazone, probenecid
    • Decreased uricosuric effect
20
Q

SSRIs

A

MAO inhibitors, meperidine, TCA, St. John’s wort

Serotonin syndrome (hypertension, tachycardia, muscle rigidity, hyperthermia, seizures)

21
Q

thiazides

A
  • Digitalis
    • increased risk of digitalis toxicity because thiazides diminish potassium stores
  • Lithium
    • Increased plasma levels of lithium due to decreased total body water
22
Q

A 55 year old patient currently receiving a drug for a psychiatric condition is to be starred on diuretic therapy for mild heart failure. Consideration should be given to the fact that thiazides are known to reduce the excretion of what drug_______

A

lithium

23
Q

A hypertensive patient has been using nifedipine for some time without untoward effects. If he experiences a rapidly developing enhancement of the antihypertensive effect of the drug, it is most likely due to

A

Furacocoumarins in grapefruit juice

24
Q

A patient suffering from a depressive disorder is being treated with imipramine. If he uses diphenhydramine for allergic rhinitis, a drug interaction is likely to occur because

A

Both drugs block muscarinic receptors

25
Q

If phenelzine is administered to a patient taking fluoxentine, which of the following is most likely to occur?

A

Agitation. muscle rigidity, hyperthermia, seizures

26
Q

Ajis a 45 year old man participating in a drug rehab program that supplies daily methadone. AJ reports that he needs more methadone to avoid withdrawal, since he started treatmetn for his tuberculosis. What drug might have caused this?

A

Rifampin

27
Q

The antihypertensive effects of captopril can be antagonized by which of the following?

A

NSAIDs

28
Q

Which drug has resulted in severe hematoxicity when adminsitered to a aptient being treated with azathioprine?

A

Allopurinol

29
Q

In patients with HIV infection, the inhibitory action of this agent on drug metabolism has clinical value

A

Ritonavir

30
Q

The drug enhances the toxicity of methotrexate by decreasing its renal clearance

A

Ibuprofen

31
Q

Concomitant use of St. John’s wort is reported to increase the effectivity of ______

A

Ibuprofen

I hate DRUGS!! (26 decks)

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